RESUMO
Most patients receiving psychiatric care are in need of a complex form of treatment combining psychiatry and psychotherapy. When these patients are admitted to hospital, this combination should not be lost: the patient will be examined and his medication regulated. However, and in contrast to classical medical care, the in-patient treatment in itself must have a positive psychotherapeutic impact on the patient. To date, psychoanalysis could provide an important contribution in maximizing the psychotherapeutic aspect of the psychiatric treatment if it takes into account current evolutions of medicine and society. Two short examples illustrate the way we combine psychoanalysis and psychiatry today.
Assuntos
Hospitais Psiquiátricos , Terapia Psicanalítica , Humanos , PsicopatologiaRESUMO
Long-term psychiatric treatments still present unsolved problems. They are interesting as far as we do our best to keep them within the general frame of reference in the working practice of our sector. Our aim here, therefore, is not to define a model which could be used everywhere, but mainly to describe the ever-questioned research of a team involved in today's psychiatry. That team chose to organise their reflexion around two polarities representing good illustrations of the whole situation as they are faced with everyday: "Crisis" and "Continuity". The purpose of "continuity" is to find out and maintain a therapeutical position which would not oversimplify the difficult problems of psychosis--that is to say avoiding the care to psychotic patients to become a routine. In order to do so, we try to use at their best the current abilities of each team member, whose multi-disciplinary capabilities allow for an individualized and diversified approach; the care-givers also try to maintain a permanent and coherent dialogue between them. This therapeutical stance is time-consuming for all members of the team, but does not require any extra equipment. The point is to organise and maintain the function of a group of caregivers around and together with a specific patient and his environment. Today's psychiatry cannot but raise the question of iatrogenicity in its interventions, of which "Chronicity" might well be one of its end-results. With the "Continuity" concept, we intend to maintain a fairly clear therapeutical relationship both with the patient and his environment, thus preventing, as far as possible, defects in the future.